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NURS 527 UNIT 3 > Unit 3-3: Prescribing for Anxiety-Based Disorders > Flashcards

Unit 3-3: Prescribing for Anxiety-Based Disorders Flashcards

1
Q

where do benzos bind?

A

GABA

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2
Q

How are the serotonin and norepinephrine systems related?

A

They have numerous reciprocal connections; a modification in one affects the other.

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3
Q

What is the role of norepinephrine in emotional memory?

A

It affects the amygdala’s beta-adrenergic receptors, causing emotionally charged events to be recorded more permanently in memory.

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4
Q

How does GABA hyperpolarize a neuron?

A

By favoring the influx of negatively charged chloride ions when activated.

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5
Q

What effect do anxiogenic GABA modulators have?

A

They reduce the effectiveness of GABA, decreasing chloride ion permeability and increasing anxiety.

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6
Q

How does the amygdala influence the experience of emotions?

A

Through connections to the cortex that affect attention, perception, and memory of dangerous situations.

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7
Q

What distinguishes the implicit and explicit memory systems during a traumatic experience?

A

The amygdala: records emotional responses
hippocampus: records details like context and time.

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8
Q

What are the two pathways of fear processing in the brain?

A

Thalamo-amygdala pathway (short route) and thalamo-cortico-amygdala pathway (long route).

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9
Q

What does the thalamo-amygdala pathway do?

A

It conveys a fast, rough impression of danger, activating the amygdala quickly.

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10
Q

What role does the thalamo-cortico-amygdala pathway play?

A

It processes information in the cortex to assess if a stimulus is a real threat before reaching the amygdala.

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11
Q

How does the hippocampus contribute to fear conditioning?

A

It encodes context and helps learn about the dangerousness of stimuli and surrounding objects.

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12
Q

What is conditioned fear?

A

A phenomenon where a neutral stimulus becomes associated with an aversive stimulus, producing anxiety.

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13
Q

What is an example of conditioned fear?

A

The sound of thunder triggering memories of a battlefield for a former soldier.

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14
Q

The sound of thunder triggering memories of a battlefield for a former soldier.

A

Extinction involves learning something new that masks the original fear, while forgetting erases the memory.

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15
Q

Which part of the brain is primarily involved in fear conditioning?

A

amygdala

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16
Q

What role does the ventromedial prefrontal cortex play in anxiety?

A

It is involved in fear extinction and the inhibition of inappropriate behavioral responses.

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17
Q

What is a classic symptom of frontal lobe damage?

A

Inability to cease inappropriate behaviors.

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18
Q

How does the prefrontal cortex relate to stress hormone levels?

A

It participates in a feedback loop that lowers stress hormone levels when they are too high.

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19
Q

Pharmacological treatment for anxiety disorders focuses on what neurotransmitters?

A

GABA, serotonin, norepinephrine, and dopamine.

20
Q

What is the primary role of dopamine in the brain?

A

It is involved in motricity, attentiveness, motivation, learning, memorization, and identifying natural rewards.

21
Q

How do some substances imitate natural neuromediators?

A

They bind to the receptors of natural neuromediators (e.g., morphine binds to endorphin receptors, nicotine to acetylcholine receptors).

22
Q

Which drug primarily increases dopamine in the synapses?

A

cocaineeeeeeeee

23
Q

What are benzodiazepines?

A

Anxiolytics that can have hypnotic or amnesia-inducing effects, such as diazepam (Valium) and clonazepam (Rivotril).

24
Q

What is the primary characteristic of benzodiazepines regarding plasma binding?

A

they are highly protein-bound in the plasma

25
Q

hat is the solubility of benzodiazepines and what does it allow?

A

Benzodiazepines are lipid soluble, allowing them to cross the blood-brain barrier easily.

26
Q

What are the benefits of SSRIs and SNRIs compared to benzodiazepines?

A

ey are non-sedating, not addictive, and less dangerous in overdose situations.

27
Q

What is the action of Tricyclic Antidepressants (TCAs) in anxiety treatment?

A

They inhibit norepinephrine and serotonin reuptake, improving sleep and concentration.

28
Q

Why can TCAs be dangerous in overdose?

A

They have a narrow therapeutic range and can cause cardiac and neurotoxicity.

29
Q

What is the function of beta-blockers in anxiety treatment?

A

They inhibit sympathetic nervous system responses, helping with somatic symptoms of anxiety.

30
Q

What is the main use of alpha-adrenergic blockers?

A

They reduce sleep disturbances and nightmares associated with PTSD

31
Q

What are Monoamine-Oxidase Inhibitors (MAOIs) primarily used for?

A

They are effective for atypical or refractory depression but are rarely used due to food and medication interactions.

32
Q

What are first-line drug classes for Generalized Anxiety Disorder?

A

SSRI, SRNI, Benzos, TCAs

33
Q

Which SNRI is commonly prescribed for Generalized Anxiety Disorder?

A

effexor

34
Q

What benzodiazepines can be used for Generalized Anxiety Disorder?

A

clonaz or diaz

35
Q

What TCAs are indicated for Generalized Anxiety Disorder?

A

Imipramine or Norpramin

36
Q

What are first-line treatments for Panic Attacks?

A

SSRI, benzo, TCA

37
Q

Which SSRIs are indicated for Social Anxiety Disorder?

A

Fluoxetine (Prozac), Paroxetine (Paxil), Fluvoxamine (Luvox)

38
Q

What TCAs can be prescribed for Panic Attacks?

A

Imipramine (Tofranil)

38
Q

What are first-line treatments for Social Anxiety Disorder?

A

SSRI, SNRI, Beta Blocker, TCA

39
Q

Which SSRIs are used for PTSD?

A

Sertraline (Zoloft), Paroxetine (Paxil), Fluoxetine (Prozac)

40
Q

What are second-line treatments for PTSD?

A

TCAs, Alpha Blocker

41
Q

Which TCAs can be prescribed for PTSD?

A

Imipramine or Desipramine

41
Q

What are additional treatments for PTSD?

A

Mirtazapine (for rumination), Trazodone (for sleep)

42
Q

What alpha blocker is used for nightmares in PTSD?

A

Prazosin

43
Q

What are first-line treatments for Obsessive-Compulsive Disorder (OCD)?

A

SSRI, TCA

44
Q

Which SSRIs are indicated for OCD?

A

Any SSRI except citalopram and escitalopram

45
Q

What TCA is commonly used for OCD?

A

Clomipramine

NURS 527 UNIT 3 (6 decks)

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